Dados do Trabalho

Título

Flank-free modified supine position versus prone position nephrolithotripsy in pediatric population: systematic review and meta-analysis

Resumo

Introduction: Percutaneous nephrolithotomy (PCNL) is the treatment of choice for kidney stones greater than 20mm in pediatric patients. The optimal patient positioning, either prone or supine, remains a subject of uncertainty in the existing literature. We aim to compare the efficacy of prone and supine PCNL positioning in the pediatric population.
Methods: We conducted a systematic review in PubMed, Embase, Scopus, Cochrane, Web of Science and Google Scholar. We included studies that compared PCNL in prone vs supine positions for pediatric patients. Our primary outcome was stone-free rate (SFR). Secondary outcomes included operative time and complications, assessed with Clavien-Dindo classification.
Results: We retrieved 4 articles, with 106 patients in the prone group and 76 patients in the supine group. The mean age of all patients was 9.17 years old. Our findings presented no statistically significant difference in SFR between the two positions (OR 0.69; CI95 0.29, 1.62; p=0.39; I2=0%). Additionally, although not reaching statistical significance, we noted a slight reduction in operative time in the supine position group (MD 7.94; -0.90, 16.78; p=0.08; I2=84%). No difference was observed regarding the total complication rate (OR 0.87; CI95 0.41, 1.83; p=0.71; I2=0%).
Conclusion: Our meta-analysis suggests that PCNL performed in the prone position is equivalent to supine PCNL in terms of SFR. As our work had a reduced number of evaluated patients, further studies and comparisons are needed to ratify our work.

Palavras Chave

Pediatrics; Percutaneous nephrolithotomy